COULD YOUR EYES BE CAUSING YOUR DIZZINESS?

Vision problems such as eye strain can cause dizziness and balance problems.

Balance is a complex task involving the interaction of three systems which work as a team to help us orient ourselves in space and keep us moving easily through our world. The vestibular system in the inner ear informs the brain about the head's position, motion and orientation in space. The proprioceptive system provides sensory feedback from muscles and joints about the body's position and motion. The eyes and their movement send information to the brain about the body's alignment and position in relation to its environment. The visual system helps regulate the other systems involved in maintaining balance. Any defect in the visual system or the healthy functioning of one of the other systems can lead to dizziness or a balance disorder.

The strong connection between the eyes and the vestibular system means that eye problems negatively affect balance. Vision plays an important role in calibrating the vestibular system through the vestibulo-ocular reflex which stabilises the gaze while the head and body are in motion. A number of visual problems can cause dizziness and balance problems. While some of these are purely visual disturbances, others may be associated with other disorders. Conditions that may cause dizziness include eye misalignment, eye muscle weakness, stroke, head injury and incorrect spectacle or contact lens prescriptions.

In many cases, eye-related dizziness is due to binocular vision problems, the inability of the eyes to work together. When a person's eyes are misaligned, the eye muscles strain to focus and provide the brain with unified and clear images. This may lead to eye strain, dizziness, disorientation, neck strain and headaches. Any visual misalignment, no matter how small or subtle, puts a great deal of stress and strain on the eye muscles, causing them to become tired and overworked.

Other visual conditions that may cause dizziness include nystagmus (involuntary uncontrolled jerky eye movements), strabismus or ‘squint' (the eyes do not look in the same direction at the same time), amblyopia or ‘lazy eye', and vertical heterophoria (one eye slightly higher than the other).

Typical symptoms of vision-related dizziness and balance problems include a spinning sensation, unsteady walking, vertigo, lightedheadedness, blurred vision, disorientation, nausea, anxiety, headache, sensitivity to light and double vision. Some people experience all of these symptoms, while others experience only a few. While occasional dizziness is not a cause for concern, frequent experiences of dizziness and loss of balance should be investigated by a medical professional.

The treatment for vision-related dizziness and imbalance depends on the cause. Most are easily treatable and have a positive outcome, but some may indicate a more serious condition. Binocular vision disorder is usually treated by correcting the misalignment between the eyes with prescription prism lenses, which bend the light entering the eyes in a way that the image seen becomes realigned.

Once the eyes are working together to create one clear image, there is no longer a constant struggle to realign vision and the strain on the eye muscles is eliminated.

After evaluating a wide range of visual skills such as ocular motor skills, eye teaming, focusing, tracking and visual processing, a neuro-optometrist may recommend a rehabilitation programme.

This personalised programme involves various techniques and exercises to treat the visual components contributing to the balance disorder, improve visual perception and processing, and strengthen the eye-brain connection.

Vestibular dysfunction often requires a multidisciplinary approach. It is frequently carried out in conjunction with vestibular therapy which is aimed at restoring balance to provide relief for the symptoms of dizziness.

In addition, the rehabilitation team may include neurologists, nurses, physiotherapists, occupational therapists, speech therapists, neuropsychologists and audiologists.